Grateful to the Dead

On the afternoon Dr. Martínez and I met to talk, after he’d given his lecture on chin dissection, we sipped icy Cokes outside the university’s food court. Inside, students lined up before franchises for pizza, hamburgers, Chinese food, Mexican food, health food. Dr. Martínez explained to me that general dentistry students at the university paid around $160 in tuition per semester and that a degree in general dentistry usually took five years, or ten semesters, to complete. After the students graduate, the government requires that they spend one year practicing at a government-run clinic. He went on to tell me that in their first semester, the students study general anatomy, and in their second semester, descriptive anatomy of the head and neck, and then topographic anatomy of the head and neck by dissection. Dr. Martínez invited me to attend on the following Tuesday his class’s first cadaver dissection. A hot, dry wind was blowing from the northeast across the campus. My eyes watered and my mouth was dry. I asked if I might first see the morgue.

“Of course,” he said. “I understand. It’s best to approach these things little by little.”

He led me across campus to a low-slung, recently built structure with many windows set high in its beige walls. He led me into the immaculate white-tiled dissection room. He showed me the six waist-high, white-tiled dissection tables, each equipped with a water hose and a shiny stainless steel drain. In the northwest corner of the room, the walk-in refrigerator hummed.

“I don’t know how many we have today,” Dr. Martínez said, gesturing to the refrigerator. “If you want to look inside, you may.”

The day after my brother died, I went to the small Oregon town where he’d lived. I saw his body at the mortuary. He’d just been delivered from the coroner. I knew in my mind that he was dead. The mortician opened the door to the room where my brother lay. I saw my brother’s body. My knees gave out from under me.

At the university’s morgue, with Dr. Martínez watching, I opened the walk-in refrigerator. Cold air poured out. The refrigerator’s interior was dark. My eyes took several seconds to adjust. I saw three bodies lying on white gurneys. Blood-spattered muslin sheets covered the bodies. The air smelled of old blood.

Dr. Martínez asked, “So, do you think you’ll be able to attend our first dissection?”

“I think I’ll be fine,” I said.

“I apologize to them.” Dr. Martínez took me by the elbow. “Every week, while I’m driving to the university to do a dissection, I apologize to the people whose bodies we use. It’s not really a prayer. It’s just something I say in my mind. An apology for what we do.”

Greek religion prohibited the desecration of corpses. But it was the Greeks who were the first to take a scientific interest in human anatomy. By the Sixth Century BCE, the Greek treatment of disease had moved away from magic and spells, and the philosopher Alcmaeon conducted the first recorded attempts at human dissection, allowing him to discover, for example, the difference between arteries and veins. Later, Plato and Aristotle taught that body and soul were separate. This notion that the body was only a shell meant that cutting on a cadaver mattered little and helped assuage the public’s disgust at the practice. By 237 BCE Herophilus of Chalcedon, a follower of Hippocrates, established the world’s first school of anatomy in Alexandria, Egypt. But people remained uncomfortable with human dissection. The advent of Christianity and the doctrine of bodily resurrection gave further reason to the public’s discomfort. Whether the Catholic Church ever officially prohibited human dissection is unclear. Some medical histories contend that the Church banned the practice. The National Catholic Bioethics Center in Boston and the Catholic Encyclopedia assert that the Church never banned the practice, and they cite numerous instances of medieval scientists in Catholic countries who conducted human dissection without Church interference.

Two centuries after Martin Luther’s death, physicians throughout Western Europe knew that without dissecting cadavers, the systematic study of human anatomy was impossible. So began what some medical historians have called the “great cadaver shortage.”

The 18th Century witnessed scenes of people scrambling to steal corpses and sell them to physicians. The bodies of the anonymous poor were always up for grabs. In London, people fought over the bodies of executed criminals. The demand for cadavers was so great that some physicians resorted to grave robbing. Public sympathy for this trend was also in short supply. In 1788, 5000 New Yorkers rioted for three days after they learned that medical students at the Hospital of the City of New York were dissecting bodies stolen from a local graveyard. And today there are professors of literature who believe that this anger, fear, and suspicion were so pervasive that they played in Mary Shelley’s imagination when in 1818 she wrote Frankenstein.

A hot, dry wind was blowing on the early afternoon Dr. Martínez and his students met at the university morgue for the first dissection. We gathered in an anteroom where we put on gauzy blue surgical gowns, surgical masks, latex gloves, and blue surgical booties. A few of the girls giggled. Dr. Martínez joked with the students about how they looked in their surgical garb, about how they struggled to get the tight gloves over their sweaty fingers.

“I try to keep it light,” he later told me. “The first time is difficult.”

We pushed through the swinging doors into the dissection room. Dr. Martínez stood before us and clapped his gloved hands together.

“This isn’t a surgical setting, but I want you to behave as though it were. Once your hands touch anything in this room, your gloves are no longer sterile. Be careful not to rub your eyes or touch your mouths. Be conscious of where your hands are and what they’re doing.”

He asked two students to enter the walk-in refrigerator and wheel out the cadaver on the far left. Four young women darted to a bench on the dissection room’s far side, where they sat with their hands wedged under their thighs. Dr. Martínez pretended not to notice.